Potassium-Magnesium Citrate Is an Effective Prophylaxis Against Recurrent Calcium Oxalate Nephrolithiasis
0022-5347/97/1586-2069$03.00/0 JOURNAL OF UROLOGY Vol. 158,2069-2073, December 1997 Copyright Q 1997 by AMERICANUROLOGICAL ASS~CIATION, INC. Printed in U.S.A. POTASSIUM-MAGNESIUM CITRATE IS AN EFFECTIVE PROPHYLAXIS AGAINST RECURRENT CALCIUM OXALATE NEPHROLITHIASIS BRUCE ETTINGER,* CHARLES Y. C. PAK, JOHN T. CITRON, CARL THOMAS, BEVERLEY ADAMS-HIJET AND ARLINE VANGESSEL From the Diuision of Research, Kaiser Permanente Medical Care Program, Oakland, California, the Department of Mineral Metabolism, Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, Department of Medicine, Kaiser Permanente Medical Center, Walnut Creek, California, Department of Urology, Kaiser Permanente Medical Center, San Francisco, California, and Kaiser Foundation Research Institute, Kaiser Foundation Hospitals, Oakland, California ABSTRACT Purpose: We examined the efficacy of potassium-magnesium citrate in preventing recurrent calcium oxalate kidney calculi. Materials and Methods: We conducted a prospective double-blind study of 64 patients who were randomly assigned to receive placebo or potassium-magnesium citrate (42 mEq. potassium, 21 mEq. magnesium, and 63 mEq. citrate) daily for up to 3 years. Results. New calculi formed in 63.6%of subjects receiving placebo and in 12.9%of subjects receiving potassium-magnesiumcitrate. When compared with placebo, the relative risk of treat- ment failure for potassium-magnesium citrate was 0.16 (95%confidence interval 0.05 to 0.46). potassium-magnesium citrate had a statistically significant effect (relative risk 0.10,95%confi- dence interval 0.03 to 0.36) even after adjustment for possible confounders, including age, pretreatment calculous event rate and urinary biochemical abnormalities.
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